Written Answers Nos. 1381-1400
1381. Deputy Maurice Quinlivan asked the Minister for Health if an MRI appointment will be expedited for a child (details supplied) who, having been referred to University Hospital Limerick to address knee swelling, has yet to receive an appointment; and if he will make a statement on the matter. [46583/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1382. Deputy Maurice Quinlivan asked the Minister for Health if a rheumatology appointment will be expedited for a child (details supplied) who, having been referred for a paediatric rheumatologist appointment at Children's Health Ireland at Crumlin, has yet to receive an appointment; and if he will make a statement on the matter. [46584/24]
View answerAs this is an operational matter relating to an individual case, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy, as soon as possible.
1383. Deputy Maurice Quinlivan asked the Minister for Health if a gastroenterology appointment will be expedited for a child (details supplied) who, having been referred for a gastroenterologist appointment at Children's Health Ireland at Crumlin, has yet to receive an appointment; and if he will make a statement on the matter. [46585/24]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1384. Deputy Matt Carthy asked the Minister for Health for an update on the efforts to ensure that a child (details supplied) will receive the treatment they need; his proposals for other children with the same condition; and if he will make a statement on the matter. [46586/24]
View answerAs this is an operational matter relating to an individual case, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy, as soon as possible.
1385. Deputy David Cullinane asked the Minister for Health if he will address the policies underpinning a matter raised in correspondence (details supplied); and if he will make a statement on the matter. [46589/24]
View answerAs per European legislation – and as transposed into Irish law as the European Communities (Quality and Safety of Human Tissues and Cells) Regulations 2006 – patients undergoing advanced fertility treatment such as IVF (in-vitro fertilisation) and ICSI (intra-cytoplasmic sperm injection) are required to undergo viral screening. This mandatory requirement screen bloods for the presence of HIV 1 & 2, Hepatitis B core antibody and surface antigen, Hepatitis C and syphilis. Section 2.3 of Schedule 3 of the 2006 Regulations states: “Where HIV 1 and 2, hepatitis B or hepatitis C test results are positive or unavailable, or where the donor is known to be a source of infection risk, a system of separate storage must be devised”. The Health Products Regulatory Authority (HPRA) holds responsibility for ensuring compliance with the 2006 Regulations; however, neither I, as Minister for Health, nor HPRA has the power to direct private assisted human reproduction (AHR) providers operating in this country to put in place the necessary facilities and systems to cater for prospective patients who have, for example, tested positive for HIV.
The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary.
This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., the six Regional Fertility Hubs located across the country) and then, where necessary, AHR (assisted human reproduction) treatment (e.g., IVF (in-vitro fertilisation) and ICSI (intra-cytoplasmic sperm injection)), with patients being referred onwards through structured pathways.
Phase One of the roll-out of the Model of Care involved the establishment, at secondary care level, of six Regional Fertility Hubs within maternity networks covering the entire country, in order to facilitate the management of a significant proportion of patients presenting with fertility-related issues at this level of intervention. Patients are referred by their GPs to their local Regional Fertility Hub.
The Regional Fertility Hubs offer patients who are experiencing challenges with their fertility both medical and surgical interventions, including: relevant blood tests, semen analysis, assessment of tubal patency, hysteroscopy, laparoscopy, fertility-related surgeries, ovulation induction and follicle tracking, so as to assist achieve natural conception. However, if all available services at secondary level care are exhausted, reproductive specialist consultants can refer clinically-indicated patients who meet the eligibility criteria for specialist AHR services such as IVF.
As part of the final phase of the roll-out of the Model of Care for Fertility, referrals for AHR treatment by one of eight HSE-approved private providers, as chosen by the eligible patient concerned, commenced in September 2023. As well as IVF and ICSI, the funding allocated is also being used to provide, again initially through private clinics, IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive treatment.
It is important to ensure that patients are clinically determined by a consultant in a Regional Fertility Hub for IVF, ICSI or IUI before being referred for such treatment, having undertaken at the Hub, as appropriate, extensive consultation, assessment, and the types of procedures and interventions outlined above which are available at the secondary care level. In this regard, numerous patients have had their fertility-related issues resolved through the six Regional Fertility Hubs without having to undergo what can be highly invasive and gruelling AHR treatment such as IVF or ICSI.
In relation to the management and care of public patients who are HIV+, within the pool of the eight private AHR providers, the HSE has informed my officials that three are currently positioned to manage women with HIV who require IUI and whose male partner is negative. If alternative advanced treatment such as IVF or ICSI is required, in which the gametes (egg or sperm) of the patients are handled and managed as part of the care, no AHR provider in Ireland is currently positioned to offer care if either the female or male is HIV+.
Any couple identified at Regional Fertility Hub level, in which one or both partners are living with HIV, who have been clinically determined as requiring AHR treatment, meet the national access criteria, and cannot be managed and cared for within the current network of HSE-approved providers will be able to receive their treatment under the HSE’s Treatment Abroad Scheme (TAS). The relevant Regional Fertility Hub, NWIHP and the TAS will work closely together in relation to meeting the needs of individual couples in this regard.
Funding has been made available to develop the first public National AHR Centre which is scheduled to open in Cork this year. NWIHP is currently working with the Cork AHR team with a view to developing in the first instance an IUI service that can manage patients living with HIV. This service is being developed in close collaboration with the infectious disease services and will involve the development of a joint package of care, such that a couple requiring IUI treatment can receive it in time in the Cork Centre and will no longer have to travel abroad. With the planned development and delivery of further advanced treatments in Cork, such as IVF, again NWIHP is working with the Cork team to assess the ability and feasibility of providing those services to patients living with HIV – thereby removing the need for any couples to travel abroad for treatment.
Whilst this work is ongoing, with a view to ultimately positioning the public service to meet the needs of individuals living with HIV in relation to the provision of advanced fertility treatment, it is important to note that no patient is being denied treatment. AHR treatment, if indicated, can and will be enabled by the HSE and its Treatment Abroad Scheme.
In conclusion, the Department of Health and the Government have been focused, through the full implementation of the Model of Care for Fertility, on ensuring that patients receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system.
1386. Deputy David Cullinane asked the Minister for Health the number of staff accommodation units currently provided by Children’s Health Ireland, by location; the number once the new Children’s Hospital is opened and other sites are vacated; and if Children’s Health Ireland has any plans for providing staff accommodation. [46590/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1387. Deputy Michael Cahill asked the Minister for Health what progress has been made in plans to provide a primary care centre in Cahersiveen, County Kerry; and if he will make a statement on the matter. [46592/24]
View answerAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond to the Deputy directly, as soon as possible.
1388. Deputy Michael Cahill asked the Minister for Health if a dedicated Lyme disease diagnosis and treatment facility can be set up, staffed and funded at University Hospital Kerry, adjacent to Killarney National Park, home of Ireland’s largest numbers of deer, largely responsible for the spread of this debilitating disease; and if he will make a statement on the matter. [46597/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1389. Deputy Michael Cahill asked the Minister for Health what progress has been made in plans to provide a primary care centre in Killarney, County Kerry; and if he will make a statement on the matter. [46606/24]
View answerAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond to the Deputy directly, as soon as possible.
1390. Deputy Emer Currie asked the Minister for Health the reason persons lose their long-term illness card for ADHD at 16 years when it is a lifelong condition; and if he will make a statement on the matter. [46624/24]
View answer1492. Deputy Paul McAuliffe asked the Minister for Health if he plans to change the criteria for the long-term illness scheme to include over-16s with a mental illness; and if he will make a statement on the matter. [1100/25]
View answer1688. Deputy Barry Ward asked the Minister for Health if he will extend the long-term illness scheme from age 16 to age 18 for mental-illness treatments; and if he will make a statement on the matter. [2112/25]
View answerI propose to take Questions Nos. 1390, 1492 and 1688 together.
The Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 conditions covered by the Scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. While there are currently no plans to extend the list of conditions, it is important to remember that the LTI Scheme exists within a wider eligibility framework.
There has been a significant focus on improving access to and the affordability of healthcare services over the last few years. This includes reductions in the Drugs Payment Scheme threshold, expansion of access to free GP care, and the abolition of all public in-patient hospital charges for children and adults. These measures continue to create a health and social care service that offers affordable access to quality healthcare.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the General Medical Services (GMS) Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drugs Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
1391. Deputy Michael Cahill asked the Minister for Health to expedite the provision of a minor injuries and diagnostic clinic on the grounds of the old District Hospital/Killarney Community Hospital, along with a primary care centre for the town; and if he will make a statement on the matter. [46627/24]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to these matters.
1392. Deputy Michael Cahill asked the Minister for Health to urgently address the chronic waiting times, especially for our senior citizens, who have been left waiting on chairs and trolleys for 24, 48 hours and longer in the accident and emergency department at University Hospital Kerry; if he will he addresses as a matter of urgency the chronic shortage of nurses and doctors there (details supplied); and if he will make a statement on the matter. [46632/24]
View answerAs our health system is in the midst of what is historically one of the most challenging periods of the year, I would like to assure the deputy that every measure is being taken to deliver the smooth running of our hospitals over the winter period including University Hospital Kerry (UHK). It is a key target of the 2024 Unscheduled Emergency Care Plan to maintain and exceed the target of 99% of all attendees aged 75 years and over at Emergency Departments (EDs) who are discharged or admitted within 24 hours of registration. There is a particular focus on 24hr PET for this age cohort to mitigate the patient safety risks associated with extended wait times. The HSE aims to achieve this target through the provision of services and protocols to maximize patient flow and ensure those in the most need are treated in good time.
These plans include the cohorting of patients in specialty or dedicated wards in particular Older Adults to specialist geriatric wards. In addition, roster amendments have been made to provide additional and extended hours for senior decision makers and staff integral to patient flow, improving the patient journey through the hospital system and maximising utilisation of the available facilities.
All EDs have plans in place to screen all patients 75 years for Delirium and Frailty at triage (or within 15 minutes of registration) and provide early access to specialist emergency and gerontology care. In UHK a designated person is rostered to keep them informed and assist as needed throughout each shift. UHK also has a Geriatric Emergency Multidisciplinary Service unit, operating a Monday to Friday service, based in the ED working with people aged 75 years and older.
As the matter of site-specific staffing is a service matter, I have asked the HSE to respond to the deputy directly.
1393. Deputy Michael Cahill asked the Minister for Health to consider the urgent need for additional nursing staff/home carers to cater for our elderly loved ones, as there is a huge shortfall of required caring staff in Kerry, with Dingle, the Iveragh peninsula, south and east Kerry being particularly badly affected; if he will provide additional nurses/carers to visit them regularly because if the present staff shortage is not dealt with people will need to return to a hospital setting, with all associated additional costs; and if he will make a statement on the matter. [46639/24]
View answerAs these are a operational matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1394. Deputy Claire Kerrane asked the Minister for Health the supports that are in place for patients who have come off the drug methadone and who now deal with tooth decay (details supplied); and if he will make a statement on the matter. [46650/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
1395. Deputy Niamh Smyth asked the Minister for Health if the case of a person (details supplied) will be reviewed and a homecare package expedited for them; and if he will make a statement on the matter. [46657/24]
View answerAs this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1396. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to allegations of potential data regulation breaches at a location (details supplied) due to certain remote work arrangements; and if he has sought or received any information regarding this from the institution concerned. [46662/24]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
1397. Deputy David Cullinane asked the Minister for Health the staffing levels and vacancies for relevant child and adolescent mental health teams covering County Waterford. [46668/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
1398. Deputy Robert Troy asked the Minister for Health if a surgery appointment for a person (details supplied) will be expedited. [46675/24]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1399. Deputy Paul Murphy asked the Minister for Health if his attention has been drawn to the cost barriers that exist for those who are looking for help with an eating disorder; if he will ensure that support is made easily accessible for all those who need it, not just those who can afford it; and if he will make a statement on the matter. [46677/24]
View answerThe Model of Care for the National Clinical Programme for Eating Disorders (NCP-ED) launched in 2018, as Minister of State for Mental Health and Older People, I have prioritised the roll out of the National Clinical Programme for Eating Disorders (NCP-ED) since taking up office in July 2020.
The NCP-ED is being implemented across the country by multidisciplinary teams on a phased basis. There are now eleven teams in place: six Adult teams and five Child and Adolescent Mental Health Services (CAMHS) teams. Six new teams started in 2023, and in May 2024, I announced the establishment of a new team for CHO7, which will cover the area of Kildare/West Wicklow, Dublin West, Dublin South City and Dublin South West. This will bring the total number of eating disorder teams nationally to twelve.
There are approximately 100 posts funded under the National Clinical Programme. Over 80 eating disorder Clinicians, including 10 Consultant Psychiatrists, are now treating people with eating disorders.
Dedicated investment in eating disorders continues, and last year the Health Service Executive (HSE) spent €8.1m on eating disorder services under the Clinical Programme. I am firmly committed to enhancing specialist services for eating disorders, including improved access and shorter waiting lists.
The HSE have informed that since 2019, the number of referrals to community specialist eating disorders teams has grown year-on-year, peaking during COVID-19 in 2021. In 2022, there was a slight decrease in the number of referrals. However, an upward trend was again reported in the latter part of 2023. This increase is in part due to increased availability of services with the number of teams delivering services augmented, and access to suitable treatment rooms coming on stream for some teams.
The HSE works hard to meet the needs of people with eating disorders in the setting most appropriate to their needs, whether that be community eating disorder teams, beds in the public system, specialist beds from private providers (funded by the HSE) or under the Treatment Abroad Scheme. Since 2020, 14 people have availed of the Treatment Abroad Scheme.
Adults who have an eating disorder diagnosis and require inpatient care can be referred to any of the 66 HSE acute in-patient mental health approved centres nationally. New pathways have been developed between the 6 specialist Adult eating disorder teams and the relevant approved centres in their particular area to provide liaison supports.
Eating disorders affect a relatively young section of the population, with over two-thirds of referrals to the National Clinical Programme last year involving young people under 18. There are currently 20 dedicated eating disorder beds across the four 4 CAMHS in-patient units. At present, there is a waiting list of three for young people to access these dedicated eating disorder beds.
Following increases in population and in demand for services, a review of the Model of Care will be undertaken and the HSE have advised the Department that preliminary work has commenced on the scoping of the review. The outcomes of this review will inform the future development of teams and eating disorder teams’ staffing requirements etc. from 2025 onwards.
The review will be undertaken by the National Clinical Programme for Eating Disorders, in collaboration with BodyWhys, the partner organisation to the Programme, and other eating disorder stakeholders. It will be informed by consultation and engagement with service users.
In addition, a review of bed capacity across all mental health facilities – including adult eating disorder beds – has taken place and is under consideration by the HSE.
As part of my continued drive to improve eating disorder services, I recently announced increased funding under Budget 2025 for two additional adult eating disorder teams. This will bring the total number of eating disorder teams nationally to 14 out the 16 teams envisaged under the Model of Care. Further details regarding the further roll out of these two teams is a matter for discussion between the Department and the HSE in order to best meet demand for Eating Disorder Services.
I remains firmly committed to enhancing specialist services for eating disorders, including improved access and shorter waiting lists.
1400. Deputy Maurice Quinlivan asked the Minister for Health if a surgery appointment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [46678/24]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
